Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy.

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our Privacy Policy and User Agreement for details.

Korean civil registration and vital statistics: use of unique identification number for universal health coverage

Presentation by Minah Kang (Ewha Womans University) at the international conference on innovations in Civil Registration and Vital Statistics (CRVS) systems - Ottawa on 27-28 February 2018. See more at http://crvsinnovations.net

Korea’s RR system is an effective policy tool as it collects and processes the personal records needed to assess population dynamics, such as residents’ residency relationships, and it integrates all essential data on individuals (M. Kim 2011). The system was introduced to enhance the convenience and efficiency of the administrative institutions and to effectively manage the people. As Korea becomes a welfare state, the RR system’s focus has shifted away from managing, controlling, and protecting the people toward service provision. In Korea, the RR number assigned at the time of birth registration provides access to benefits through national health insurance from that point until death. Korean citizens are sent letters about free health check-ups, and they receive a variety of services tailored to each life stage. In addition, the information that individuals report on their family relationships, such as births, deaths, marriages, and divorces is used to investigate population dynamics and is important for understanding society

대상정보 확대 : 1종(147종 → 148종) - 이용기관 확대 : 행정293, 공공121, 금융17, 교육186 → 행정294, 공공124, 금융20, 교육188 - 정보유통서비스 기관 및 정보확대 구축 (대량정보유통서비스 212종 확대, 사실여부 확인서비스 3종 확대, 실시간정보유통 60종 확대, 맞춤정보유통 11종 확대) - 공동정보이용 정보보안 및 개인정보보호체계 추진(ISMS인증유지 심사추진, 공동이용 대상 확대 및 서비스 다양화에 따른 개인정보 영향평가 실시, 시스템 성능 진단 및 보안취약점 점검 및 보완) 공동이용 활성화를 위한 사용자 교육 The ease of accessing and using existing and common administrative information has led to the merger of major databases across the government and the reform of related services. A nationwide administrative information sharing system has evolved, which incorporates the Public Information Sharing Center (PISC), a center that oversees standards for the use of common administrative information and plans for necessary systemic and institutional reforms. The new system has streamlined the administrative information networks at different ministries and departments. While the Center performs the tasks of developing and maintaining common databases, an Inter-Departmental Public Information Sharing Review Committee coordinates opinions among departments and ministries. The new administrative information sharing system enables civil servants to access and view 42 types of administrative information across 12 categories (i.e., resident registration, real estate, car registers, ships, businesses, taxes, veterans’ affairs, awards and decorations, military affairs, legal affairs, patents), which they are required to provide administrative services to residents. The sharing system has radically simplified the paperwork involved in administrative tasks and thus streamlined administrative procedures

Patient’s Side Access: National Health Insurance (NHI) is linked to the Universal Identification Number (UIN), which ensures the primary accessibility of care for the entire population. Affordability: According to individual economic condition and type of disease, OOP varies greatly. The specific condition of individual can be checked via UID. Contribution: The NHIS has been able to investigate income and property information for subscribers in connection with their UIN. Provider’s Side Reimbursement: The provider registers the license number and medical institution number into the NHI system using the UIN. Then the reimbursement is requested by the NHIS for the services provide Performance valuation: The HIRA evaluates the quality of medical care based on data provided by the provider as to the license and medical care agency number associated with UIN. Expenditure control: Healthcare providers are subjected to various monetary and non-monetary incentives or disincentives that are applied according to the treatment and prescription data requested based on the license and medical care institution number associated with the UIN.

Public Agency’s Side Coverage Enhancement: A diagnosis of one of the four major serious diseases is recorded in the patient’s billing record related to the UIN, and the government applies a separate insurance standard with extended protections Evidence-based decision: In order to decide whether to be included in the benefit list. Therefore, although it is outside of the health insurance structure, registered patients who are identified by the UIN are required, and the process must be carried out under the regulation of the system. Sustainability and innovation: The information can create unlimited data and basis for study only under the premise that personal information related to a patient’s UIN is thoroughly protected.

An independent Medical Information Protection Act At present, there are no regulations for comprehensive privacy protections and the security of the protections of personal health data in Korea. an independent healthcare information protection law should be enacted soon regarding management of patient data, which has become copious because of computerization (Bang 2014; Jung 2008). Non-identification of personal information Korea does not have a reliable and consistent system for protecting health data, and “non-identification of personal information” that might minimize the risk of data theft has become an important way to protect personal information (Park et al. 2016). Non-identification of information is an important way to effectively protect personal information in the Big Data industry. Non-identification of data might enhance the uses of personal information and activate personal information for research as strictly controlled by the 2011 PIPA. However, non-identification still is limited because it does not eliminate the risk of re-identification. Therefore, it is necessary to develop appropriate substantive and technological devices and apparatuses (Ko et al. 2015).

Korean civil registration and vital statistics: use of unique identification number for universal health coverage

2.
CRVS as a UHC Tool
• Detector: “Instruments
government uses for taking in
information”
• Effector: “Tools government can
use to try to make an impact on
the world outside”
Source: Hood, Christopher C., and Helen Z. Margetts. The tools of
government in the digital age. Palgrave Macmillan, 2007; Y. Kim and M. Kang
(2016). Policy tool choice and mix based on policy objectives and
government resources: Case study of civil registration system in Korea
UHC Cubic Model
Roberts MJ, Hsiao WC, Reich MR.
Disaggregating the universal coverage
cube: putting equity in the picture.
Health Systems & Reform 2015; 1(1): 22-
27.

6.
Case study: Prevention
Vaccination Health
promotion
and MCH
project
Under-
nourished
Children’s
Meal Aid
Project
Nutri Plus
Program
Enroll-
ment
Register
vaccination
history in the
National
Immunization
Registry
Identify
individuals by
UID at each
local public
health center
investigate the
personal
information
and home
environment of
the recipient
child
Pregnant
mothers to
receive
nutritional
supplement
support
Mgmt
Medical
institution
confirmation;
inoculated
person manage
their own history
long-term
epidemiologi-
cal study on
chronic
disease &
promotion
Issue electronic
meal card to
the family
Registering
history and
the result of
nutritional
assessment
Review &
Feedback
Report the
adverse reaction,
Continuous
review and
feedback
Medical
expense
support and
reimburse-
ment
Reevaluate the
child's
eligibility.
feedback and
evaluation of
the program
Eligibility
reevaluation
process
UID for Disease Prevention and Health Promotion
MOI
Resident
Registration
Information
System
MOHW
Social
Welfare
Integrated
Information
System
MOE
National
Education
Information
System
KCDC
Vaccina-
tion
System
Managed
by the RR
number
NHIS
Medical
Institu-
tions
Local
public
health
centers
Citizens
(Children
and
Guardians)
Birth and
Death
Information
Welfare
History
Student
Information
Provide
Vaccina-
tion
History
Provide
Vaccination
History
Provide
Vaccination
History
Register
Vaccination
History
Register
Vaccination
History
Infant
Health
Examination
Vaccination
Subject
Management
Vaccination
Confirm
vaccination
Alert and encourage
issuance of immunization certificate
The Vaccination Information System
Source: Korea Centers for Disease Control and Prevention (2015). 2015 Guidelines for the
Administration of Children’s National Immunization Program

8.
Case study: Health Insurance
National Health
Insurance
Medical
Care Insurance
Enrollment
Health insurance
subscription
Registration of eligible
beneficiaries;
Special computer
administration number
is given to those without
UID
Mgmt
Health insurance card is
issued; The card includes
birth date and control
number
Medical institution
confirms eligibility of the
patients and manage the
service plans
Review &
Feedback
Healthcare providers send
patient's personal
information for billing
Systematic evaluation of
beneficiary and feedback
process
Using UID for National Health Insurance System
Diagram on the National Health Insurance Data System
(Source: Park Jong Heon (2015). National Health Insurance Data System and Resident
Registration Number in Korea, CRVS Forum in Seoul, December 7, 2015)